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Sleep disturbance and cognitive decline in multiple sclerosis patients with isolated optic neuritis as the first demyelinating event

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Abstract

Purpose

Multiple sclerosis (MS) patients whose first demyelinating event is optic neuritis have been claimed to display a milder disease course and reduced physical disability. Our aim was to investigate the impact of the clinical features of the first clinical episode on cognitive disability and sleep dysfunction in MS.

Methods

A total of 26 (10 with optic neuritis as the first clinical event) MS patients were recruited. A comprehensive sleep study was performed, and a panel of tests were administered to examine cognitive and motor performance. Serum levels of sleep-related mediators orexin-A and melatonin were measured by enzyme-linked immunosorbent assay. Subjective sleep quality was evaluated by Pittsburgh sleep quality test, and daytime excessive sleepiness was tested by Epworth sleepiness scale.

Results

MS patients with the first clinical episode of optic neuritis and patients with at least one optic neuritis attack exhibited increased daytime sleepiness, higher sleep efficiency and NREM duration and lower total wake time. Patients with a history of optic neuritis obtained more favorable scores in neuropsychological tests measuring executive functions and complex attention as compared to those who had never experienced optic neuritis. Melatonin and orexin-A levels were lower in patients with optic neuritis onset. The higher no. of optic neuritis attacks was associated with reduced wake time and higher symbol digit modalities test scores.

Conclusions

Having a history of optic neuritis is associated with improved sleep quality and executive functions but increased daytime sleepiness. Reduction of orexin-A and melatonin levels might be one of the underlying mechanisms.

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Funding

This study was supported by Istanbul University Research Projects Fund, Project No. 30783.

Author information

Authors and Affiliations

  1. Department of Neurology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey

    Recai Türkoğlu & Mehmet Gencer

  2. Department of Neurology, Cerrahpaşa Faculty of Medicine, İstanbul University Cerrahpaşa, Istanbul, Turkey

    Gülçin Benbir, Selen Özyurt, Erdil Arsoy, Selin Turan & Derya Karadeniz

  3. Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey

    Ece Akbayır, Vuslat Yılmaz & Erdem Tüzün

Authors
  1. Recai Türkoğlu
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  2. Gülçin Benbir
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  3. Selen Özyurt
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  4. Erdil Arsoy
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  5. Ece Akbayır
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  6. Selin Turan
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  7. Derya Karadeniz
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  8. Vuslat Yılmaz
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  9. Mehmet Gencer
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  10. Erdem Tüzün
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Corresponding author

Correspondence to Erdem Tüzün.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Türkoğlu, R., Benbir, G., Özyurt, S. et al. Sleep disturbance and cognitive decline in multiple sclerosis patients with isolated optic neuritis as the first demyelinating event. Int Ophthalmol 40, 151–158 (2020). https://doi.org/10.1007/s10792-019-01157-x

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  • DOI: https://doi.org/10.1007/s10792-019-01157-x

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